Liver Cancer Treatment in Delhi, India

Liver cancer, also known as hepatocellular cancer, is a cancer that originates in the liver itself. Tumours that originate in the colon, lung, breast, pancreas, stomach, and other organs and spread to the liver through the bloodstream can also give rise to liver cancer. If the cancer originates in another part of the body and spreads to the liver, it is known as liver metastases. Max Hospitals provide one of the best liver cancer treatments in Delhi, India.

There are following main types of liver cancer, according to the best liver cancer hospitals in India. All these types of liver cancers are serious and have a tendency to recur.

1. Primary liver cancers

Hepatocellular Carcinoma (HCC)

HCC or hepatoma is the most common type of liver cancer. In most cases, it occurs because of hepatitis B or C. Cirrhosis of the liver caused due to alcohol abuse is another reason.

Fibrolamellar HCC

This is a rare type of Liver cancer and more responsive to treatments. It typically occurs in young adults between the ages of 20 to 40 without any gender predilection. Unlike Hepatocellular Carcinoma (HCC), Fibrolamellar HCC does not have any association with cirrhosis, hepatitis or alcoholism

Intrahepatic Cholangiocarcinoma

This type of liver cancer occurs in the bile ducts of the liver, resulting in intrahepatic and extrahepatic bile duct cancer. It accounts for 10-20% of all liver cancers.

Angiosarcoma

It starts in the blood vessels of the liver and proliferates. It is diagnosed at an advanced stage.

Hepatoblastoma

It is a rare cancer that occurs in children. 

2. Secondary Liver Cancer

Secondary liver cancer takes place when cancer originates in another part of the body and later spreads to the liver.

Initially, the liver cancer symptoms might not occur at all. The patient will start witnessing some of the symptoms after the cancer increases. Below mentioned are a few symptoms that you might feel if liver cancer has been detected.

• Unexplained weight loss
• Loss of appetite
• Fatigue
• Swelling or fluid build-up in the abdominal area
• Lump in the abdomen
• Jaundice
• White, chalky stools
• An enlarged liver
• Nausea
• General weakness and fatigue
• Vomiting
• Abdominal Pain
• Fever
• Itching

Recognizing symptoms early and seeking medical help without delay provides numerous benefits, including a broader range of treatment choices and an enhanced quality of life during and after treatment. So, in case of any symptoms, it is crucial to act promptly by seeking immediate medical attention to ensure the best possible outcomes.

Liver cancer has a number of known causes, such as. 

• Cirrhosis, a condition where the liver cells are damaged and replaced with scar tissues. People with this health condition develop higher chances of liver cancer.
• Hepatitis B infection
• Hepatitis C infection
• Diabetes
• Non-alcoholic fatty liver disease, NASH or non-alcoholic steatohepatitis.
• Family history can also be the cause in some cases
• Alcohol abuse and smoking
• Prolonged use of anabolic steroids can significantly increase the risk of developing liver cancer
• Certain inherited liver diseases (Haemochromatosis & Wilson’s Disease)
• Aflatoxins are substances made by a fungus and are found in mouldy wheat, groundnuts, corn, nuts, soybeans, and peanuts. Excess intake of these substances may lead to a tumour in the liver.

It is important to note that not everyone who is at a higher risk of liver cancer will develop the disease. However, it is important to be aware of the risk factors so that one can take steps to reduce their risk, such as getting vaccinated against hepatitis B, limiting alcohol intake, and maintaining a healthy weight. If you are concerned about the risk of developing liver cancer, talk to a liver cancer doctor in Delhi. They will help you assess your risk and suggest a plan to reduce it.

• Blood tests: These tests help check how well the liver is functioning and look for certain chemicals in the blood that may be signs of cancer.
• Imaging tests: These tests, such as ultrasounds, CT scans, and MRIs, create images of the liver to look for tumours or other abnormalities.
• Liver biopsy: This procedure involves removing a small sample of liver tissue for examination under a microscope. A liver biopsy is usually only necessary if other tests are not able to provide a definitive diagnosis. Liver biopsy is a relatively safe procedure, but it does carry some risks, such as bleeding, bruising, and infection.

Diagnosis is the first step to successful treatment of any disease, including liver cancer. Max Healthcare offers the latest diagnostic technologies, enabling early and accurate diagnosis of liver cancer, giving patients the best possible chance of recovery. We also have a team of experienced and highly skilled doctors who specialise in liver cancer diagnosis. This team works together to interpret the results of diagnostic tests and make a definitive diagnosis.

Liver cancer is staged using a system called the TNM system. This system takes into account the following factors:

• T: The size and location of the tumour
• N: The number of lymph nodes that are involved with cancer
• M: Whether the cancer has spread to other parts of the body

The TNM system is used to assign a stage to the cancer, which ranges from stage 0 to stage IV. Stage 0 is the earliest stage of liver cancer, and stage IV is the most advanced stage.

The prognosis for liver cancer depends on the stage of the disease at diagnosis. Early-stage liver cancer has a much better prognosis than late-stage liver cancer. However, even late-stage liver cancer can be treated and managed, and some patients can live for many years with the disease.

If a person is diagnosed with liver cancer, a liver oncologist will talk to them about the stage of the disease and their prognosis. The liver oncology specialist will also work with them to develop a treatment plan that is right for them.

The right liver cancer treatment for a patient diagnosed with liver cancer depends on a number of factors, including the type and stage of the disease, as well as the person's overall health. The most common treatment options for liver cancer include:

Surgery

Partial Hepatectomy

Liver Transplant

• Deceased Donor Liver Transplantation (DDLT) 
• Living Donor Liver Transplantation (LDLT)

Liver transplant is an option only for a small percentage of people with liver cancer. It is usually considered for people with early-stage liver cancer who are otherwise healthy.

Radiotherapy

Chemotherapy 

Targeted Drug Therapy

Targeted drug therapy is a type of cancer treatment that uses drugs to attack specific parts of cancer cells. This can help to kill the cancer cells without harming the healthy cells in the patient’s body. There are many different targeted drug therapies available for liver cancer. Some of these drugs only work for people whose cancer cells have certain gene changes. To see if targeted drug therapy is right for a patient, their cancer cells will first be tested for these gene changes.

Immunotherapy

Immunotherapy is a type of liver cancer treatment that helps the body's own immune system fight the cancer. The immune system is the body's natural defence system against infection and disease. Cancer cells can sometimes hide from the immune system, but immunotherapy drugs can help the immune system find and destroy cancer cells. Immunotherapy treatments are often used for people with advanced liver cancer, but they can also be used for people with earlier stages of the disease.

Liver Cancer Treatment is administered directly to the cancer cells or the area surrounding the cancer cells. Options include:

• Heating cancer cells: Using ultrasound or CT scan as a guide, your surgeon inserts one or more thin needles into small incisions in your abdomen. On reaching the tumour, the needles are heated with an electric current, destroying the cancer cells.
• Freezing cancer cells: Cryoablation uses extreme cold to destroy cancer cells. During the procedure, your doctor places an instrument (cryoprobe) containing liquid nitrogen directly onto liver tumours. Ultrasound images are used to guide the cryoprobe and monitor the freezing of the cells.
• Injecting alcohol into the tumour: During alcohol injection, pure alcohol is injected directly into tumours, either through the skin or during an operation. Alcohol causes the tumour cells to die. Injecting chemotherapy drugs into the liver. 
• Placing beads filled with radiation in the liver: Tiny spheres that contain radiation may be placed directly in the liver where they can deliver radiation directly to the tumour. This is called transarterial radioembolization (TARE).
• Blocking the blood supply and giving chemotherapy directly: involves injecting chemotherapy drugs directly into the blood vessels that supply the tumour, followed by blocking the blood flow to the tumour. This is called transarterial chemoembolization (TACE).

After a successful liver cancer treatment, you too can live a normal life and resume your daily activities. It is important to follow the directions given by your doctor. Post-treatment, the patient is required to make healthy choices and efforts to stay fit. It will indeed take some time for the patient to recover completely both physically and mentally. Here are a few things that can help the patient in recovering fast.

• Take adequate rest and give some time for self
• Do not include tasks in your work routine that require strenuous efforts from your end
• Avoid it for at least some time post the treatment
• Socialise more, it will help in making you feel better
• Exercise regularly, but moderation should be the key
• Start having a healthy diet with lots of green vegetables and avoid junk food
• In case of discomfort, visit the physician at the earliest

The physician offering liver cancer treatment in India will conduct periodic medical check-ups to monitor whether cancer has recurred. A series of physical examinations, medical tests, or both methods can be used as follow-up care by the concerned physician. The doctor will also check whether there are any side effects of the treatment. Whatever changes you feel in your body post-treatment, let your physician be aware of it, so that a proper follow-up care routine is designed.

Max Institute of Cancer Care (MICC) at Max Hospitals, India, is one of the leading facilities in India, which offers the latest treatments under surgical oncology, radiation oncology, and medical oncology. It is one of the largest Cancer Centres in North India, with presence in Saket, Patparganj, Shalimar Bagh, Vaishali, Mohali and Bathinda. It offers high-end treatments like cone-beam CT and ExacTrac.

Diagnostic tests and procedures for liver cancer include:

• Blood Tests
• Liver function tests
• Imaging Tests (Sonography, CT Scan and MRI)
• Liver biopsy

With over 100 oncologists, we provide world-class treatment facilities and focused care to cure liver cancer. We have the best cancer specialists, many of whom specialise in treating liver cancer. Each patient receives an individualised treatment plan, made by a multidisciplinary team of medical oncologists, radiation oncologists, surgeons, histopathologists, pathologists, dieticians, physiotherapists, geneticists and other healthcare professionals.

At Max Institute of Cancer Care, we know that cancer treatment involves multiple specialities (Surgical, medical and radiation oncology, molecular oncology, pathology, radiology, palliative oncology, psycho-oncology, onco-rehabilitation, etc.), and the best outcome in any patient can be ensured only if all decisions are taken collectively by all specialists involved.

Therefore, a Tumour Board of such specialists who meet periodically and discuss the best approach to the management of cancer patients is facilitated. It ensures that many heads are planning holistic management of a patient.

Liver cancer is treated by involving complete medical history and physical examination, and diagnostic procedures. A series of physical examinations, medical tests, or both methods can be used as follow-up care by the concerned physician.

For a liver cancer patient, the right treatment is determined based on the age, overall health, medical history, extent of the disease, tolerance of specific medicines, procedures, or therapies, expectations for the course of the disease and the patient’s opinion or preference.

The doctor will also evaluate the side effects of the treatment. Whatever changes you feel in your body post the treatment, let your physician be aware of it, so that a proper follow-up care routine is designed.

1. What are the types of liver cancer?

There are various types of liver cancer, including hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), hepatoblastoma, and various other relatively uncommonly seen cancers.

2. What are the common risk factors for liver cancer?

Common risk factors for liver cancer include chronic infection with hepatitis B or C, cirrhosis, excessive alcohol consumption, non-alcoholic fatty liver disease (NAFLD), and exposure to aflatoxins.

3. What are the common symptoms of liver cancer?

Symptoms of liver cancer include abdominal pain, unexplained weight loss, fatigue, jaundice, loss of appetite, and swelling in the abdomen.

4. How is liver cancer diagnosed?

Liver cancer is usually diagnosed through imaging tests, such as an ultrasound or CT scan.

5. What are the stages of liver cancer?

Liver cancer is typically staged using the TNM system, which takes into account the size and location of the tumour, as well as whether it has spread to other parts of the body.

6. How is liver cancer treated?

Treatment of liver cancer depends on various factors, including the stage of the cancer, the condition of the underlying liver (functional status of the liver) and the patient's overall health and may include surgery, radiation therapy, targeted therapy, chemotherapy, immunotherapy, and ablation techniques.

7. What are the surgical options for liver cancer treatment?

Surgical options for liver cancer treatment include resection, in which part of the liver is removed, and liver transplantation.

8. hat is liver transplantation for liver cancer?

Liver transplantation involves replacing the diseased/damaged liver with a healthy liver from a donor and can be an effective treatment option for early-stage liver cancer.

9. What are the non-surgical treatment options for liver cancer?

Non-surgical treatment options for liver cancer include ablation techniques (such as radiofrequency ablation, cryoablation, microwave ablation, transarterial chemoembolization, transarterial radioembolization), radiation therapy, chemotherapy, targeted therapy, and immunotherapy.

10. What is targeted therapy for liver cancer?

Targeted therapy uses drugs that target specific proteins or genes in cancer cells to stop their growth and spread.

11. What is immunotherapy for liver cancer?

Immunotherapy uses the body's immune system to fight cancer cells and is a newer treatment option for liver cancer.

12. What is cryoablation for liver cancer?

Cryoablation for liver cancer is a minimally invasive interventional radiologic technique that uses extreme cold temperatures to destroy cancerous tissue in the liver. During the procedure, a thin probe called a cryoprobe is inserted into the liver tumour, and liquid nitrogen or argon gas is circulated through the probe to create an ice ball that freezes and destroys the cancer cells. Cryoablation is often used as an alternative treatment for liver cancer patients who cannot undergo surgery or who have tumours that cannot be treated with other treatment modalities, such as chemotherapy or radiation therapy. 

13. What is transarterial chemoembolization (TACE) for liver cancer?

TACE is a type of targeted therapy that involves injecting chemotherapy drugs directly into the blood vessels that supply the tumour, followed by blocking the blood flow to the tumour.

14. What is transarterial radioembolization (TARE) for liver cancer?

TARE is a type of targeted therapy that involves injecting radioactive particles directly into the blood vessels that supply the tumour, causing the radiation to kill the cancer cells.

15. What is microwave ablation for liver cancer?

Microwave ablation is a minimally invasive procedure that uses microwave energy to destroy cancer cells in the liver.

16. Can liver cancer be prevented?

While it is not always possible to prevent liver cancer, there are several steps you can take to reduce your risk. This includes getting vaccinated against hepatitis B, avoiding exposure to hepatitis C, getting treated for hepatitis B and C as needed, limiting alcohol consumption, maintaining a healthy weight, and managing diabetes.

17. What are the dietary guidelines for liver cancer prevention?

You should aim to eat a diet that is high in fruits, vegetables, whole grains, and lean protein sources and low in saturated fats, red meats, and processed foods. It's also important to limit your intake of alcohol and sugar-sweetened beverages.

18. What is the role of hepatitis B and C in liver cancer?

Hepatitis B or C virus is a significant risk factor for liver cancer. These viruses can cause ongoing inflammation in the liver, which can lead to the development of liver cancer over time.

19. What is the role of non-alcoholic fatty liver disease (NAFLD) in liver cancer?

Non-alcoholic fatty liver disease (NAFLD) is a condition where excess fat accumulates in the liver. It is a significant risk factor for liver cancer, particularly in individuals with advanced fibrosis or cirrhosis.

20. What is the role of genetics in liver cancer?

Genetics can play a role in the development of liver cancer, particularly in individuals with a family history of liver cancer or certain genetic mutations. Genetic testing may be recommended for individuals with a family history of liver cancer.

21. What is irreversible electroporation for liver cancer?

Irreversible electroporation (IRE) is a minimally invasive procedure that uses electrical currents to destroy cancerous cells in the liver. It is used to treat liver tumours that are not suitable for surgery or other treatments.

22. What is high-intensity focused ultrasound (HIFU) for liver cancer?

High-intensity focused ultrasound (HIFU) is a non-invasive treatment that uses high-frequency sound waves to heat and destroy cancer cells in the liver. It is used to treat small liver tumours that are not suitable for surgery or other treatments.

23. What is the prognosis for liver cancer?

The prognosis for liver cancer depends on several factors, including the stage of cancer, the size of the tumour, whether cancer has spread to other parts of the body, the condition of the underlying liver (functional status of the liver) and the overall health of the patient. The earlier the cancer is detected and treated, the better the prognosis.

24. What is the survival rate for liver cancer?

The survival rate for liver cancer varies depending on several factors, including the type of liver cancer and the stage of cancer, the size of the tumour, the condition of the underlying liver (functional status of the liver) and the overall health of the patient.

25. What is Deceased Donor Liver Transplant (DDLT)?

In this case, the diseased liver of the patient is replaced with a healthy liver from a donor who has died recently. To avail DDLT, a patient has to go through a number of tests for the doctors to determine if the patient is fit for transplant. Once the tests are through, patients get enrolled in the waiting list for the liver transplant.

26. What is Living Donor Liver Transplant (LDLT)?

In this case, the patient with a diseased liver receives a part of the liver from family or a friend. Patient’s damaged liver is replaced with the healthy one, which eventually grows on later to its normal size. It is the preferred transplant option where the patient needs immediate transplantation and a DDLT is not feasible.

27. What are the non-transplant treatment options for liver tumour?

Here are the non-transplant options for treating liver tumour cancer.

• Radiofrequency Ablation: Also known as RFA, it is a non-transplant surgical option used to kill cancerous cells. It is a minimally invasive medical procedure that is performed using local anaesthesia. This liver tumour treatment employs image guidance to place a needle through the skin into a liver tumour. Using a probe, a high-frequency electrical current is passed through the needle which creates heat to destroy the cancer cells. RFA has a high success rate and is the recommended treatment option where surgery is not feasible.
  
  
• Partial Hepatectomy: An entire part of the liver is removed, ranging from a smaller section to an entire lobe in partial hepatectomy.

28. What are the cure rates for different types and stages of liver cancer?

The cure rates for liver cancer vary depending on the type and stage of the cancer, as well as the patient's overall health. For early-stage liver cancer, the cure rates can be very high. For example, the 5-year survival rate for people with stage I hepatocellular carcinoma (HCC) is over 90%. However, the cure rates for advanced-stage liver cancer are lower. The 5-year survival rate for people with stage IV HCC is only about 3%.

29. What is the average life expectancy for patients with different types and stages of liver cancer?

The average life expectancy for patients with liver cancer also varies depending on the type and stage of the cancer, as well as the patient's overall health. For people with early-stage HCC, the average life expectancy is close to normal. However, for people with advanced-stage HCC, the average life expectancy is much shorter.

30. What are the cure rates for early-stage liver cancer?

The cure rates for early-stage liver cancer are very high. For example, the 5-year survival rate for people with stage I HCC is over 90%. This is because early-stage liver cancer is often localised to the liver, and it can be completely removed with surgery.

31. What are the treatment options for advanced-stage liver cancer?

The treatment options for advanced-stage liver cancer depend on the type and stage of the cancer, as well as the patient's overall health. Treatment options may include surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy. In some cases, a combination of two or more types of treatment is used.

32. When should I see a liver cancer specialist?

• Chronic hepatitis B or C infection
• Cirrhosis
• Nonalcoholic fatty liver disease (NAFLD)
• Alcohol abuse
• A family history of liver cancer

33. How much does it cost to see a liver cancer specialist?

The cost to see a liver cancer specialist will vary depending on your insurance coverage and the location of the specialist. However, most insurance plans will cover the cost of seeing a specialist if you have a referral from your primary care doctor.

34. Will my insurance cover the cost of seeing a liver cancer specialist?

Most insurance plans will cover the cost of seeing a liver cancer specialist if you have a referral from your primary care doctor. However, it is important to check with your insurance company to confirm your coverage.

35. Who should be screened for liver cancer?

Anybody who is at a high risk of developing liver cancer must be screened for it. High-risk groups for liver cancer include:

• People with chronic hepatitis B or C infection
• People with cirrhosis
• People with NAFLD
• People who abuse alcohol
• People with a family history of liver cancer

36. What are the factors that affect the life expectancy of liver cancer patients?

The factors that affect the life expectancy of liver cancer patients include the type and stage of the cancer, the patient's overall health, and the patient's response to treatment.

37. What is the best treatment for liver cancer at Max hospital?

The best treatment for liver cancer at Max hospital will depend on the type and stage of the cancer, as well as the patient's overall health. Treatment options may include surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy. In some cases, a combination of two or more types of treatment is used.

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